ISSN: 1859 - 2872
Pancreatitis and cholangitis in IgG4-related disease: Two cases report
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Abstract
Immunoglobulin G4-related disease is an immune-mediated fibroinflammatory condition that can affect multiple organs. We report two cases of IgG4-RD diagnosed by imaging, serum IgG4 and histopathology. The first case was a 58-years-old male with a medical history of cholecystectomy and pancreatic pseudocyst drainage surgery who presented with symptoms of biliary obstruction and recurrent pancreatitis. CT/MRI showed diffuse sausage-like swelling of the pancreas. The result of histopathology and serum IgG4 were typical of IgG4-RD and the patient rapidly responded to treatment of corticosteroid. The second case was a 77-years-old male with a medical history of idiopathic pancreatitis who presented with symptoms of biliary obstruction and acute recurrent pancreatitis. An abdominal CT scan showed diffuse sausage-like swelling of the pancreas, sclerosing cholangitis with thickening and enhancement of the common bile duct wall. Serum IgG4 level was highly elevated. The patient was diagnosed with IgG-RD and responded well to corticosteroid therapy. IgG4-RD is generally seen in males in their sixth to seventh decade of life and can involve one or multiple organs. It should be considered in patients presenting with suspect symptoms.
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References
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